EP2967731A1 - Cathéter d'ablation à irrigation ouverte ayant un refroidissement proximal - Google Patents
Cathéter d'ablation à irrigation ouverte ayant un refroidissement proximalInfo
- Publication number
- EP2967731A1 EP2967731A1 EP14715792.9A EP14715792A EP2967731A1 EP 2967731 A1 EP2967731 A1 EP 2967731A1 EP 14715792 A EP14715792 A EP 14715792A EP 2967731 A1 EP2967731 A1 EP 2967731A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- proximal
- electrode tip
- tip body
- fluid
- distal
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
- 238000002679 ablation Methods 0.000 title claims abstract description 36
- 238000001816 cooling Methods 0.000 title claims description 18
- 230000002262 irrigation Effects 0.000 claims abstract description 45
- 238000003973 irrigation Methods 0.000 claims abstract description 45
- 239000012809 cooling fluid Substances 0.000 claims abstract description 27
- 239000012530 fluid Substances 0.000 claims description 116
- 238000013507 mapping Methods 0.000 claims description 44
- 238000004891 communication Methods 0.000 claims description 9
- 238000000034 method Methods 0.000 abstract description 13
- 229910001000 nickel titanium Inorganic materials 0.000 description 25
- 239000000463 material Substances 0.000 description 22
- HLXZNVUGXRDIFK-UHFFFAOYSA-N nickel titanium Chemical compound [Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni] HLXZNVUGXRDIFK-UHFFFAOYSA-N 0.000 description 16
- -1 for example Substances 0.000 description 12
- 238000000576 coating method Methods 0.000 description 10
- 239000004020 conductor Substances 0.000 description 10
- 229910001220 stainless steel Inorganic materials 0.000 description 10
- 239000010935 stainless steel Substances 0.000 description 10
- 229910045601 alloy Inorganic materials 0.000 description 8
- 239000000956 alloy Substances 0.000 description 8
- 230000000694 effects Effects 0.000 description 8
- BASFCYQUMIYNBI-UHFFFAOYSA-N platinum Chemical compound [Pt] BASFCYQUMIYNBI-UHFFFAOYSA-N 0.000 description 8
- 229910001182 Mo alloy Inorganic materials 0.000 description 7
- 230000006870 function Effects 0.000 description 7
- 229920000642 polymer Polymers 0.000 description 7
- 206010003119 arrhythmia Diseases 0.000 description 6
- 230000006793 arrhythmia Effects 0.000 description 6
- 230000015572 biosynthetic process Effects 0.000 description 6
- 208000007536 Thrombosis Diseases 0.000 description 5
- 239000011248 coating agent Substances 0.000 description 5
- 239000000203 mixture Substances 0.000 description 5
- PXHVJJICTQNCMI-UHFFFAOYSA-N Nickel Chemical compound [Ni] PXHVJJICTQNCMI-UHFFFAOYSA-N 0.000 description 4
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 4
- 239000002826 coolant Substances 0.000 description 4
- 238000013461 design Methods 0.000 description 4
- 229910000856 hastalloy Inorganic materials 0.000 description 4
- 230000003902 lesion Effects 0.000 description 4
- 229910052751 metal Inorganic materials 0.000 description 4
- 239000002184 metal Substances 0.000 description 4
- 229910052697 platinum Inorganic materials 0.000 description 4
- 229920001343 polytetrafluoroethylene Polymers 0.000 description 4
- 239000004810 polytetrafluoroethylene Substances 0.000 description 4
- RTZKZFJDLAIYFH-UHFFFAOYSA-N Diethyl ether Chemical compound CCOCC RTZKZFJDLAIYFH-UHFFFAOYSA-N 0.000 description 3
- 229920000106 Liquid crystal polymer Polymers 0.000 description 3
- 239000004977 Liquid-crystal polymers (LCPs) Substances 0.000 description 3
- 239000004952 Polyamide Substances 0.000 description 3
- 229920002614 Polyether block amide Polymers 0.000 description 3
- 239000004642 Polyimide Substances 0.000 description 3
- 239000004721 Polyphenylene oxide Substances 0.000 description 3
- 230000001594 aberrant effect Effects 0.000 description 3
- 238000005452 bending Methods 0.000 description 3
- 238000001125 extrusion Methods 0.000 description 3
- 229920001903 high density polyethylene Polymers 0.000 description 3
- 239000004700 high-density polyethylene Substances 0.000 description 3
- 238000002595 magnetic resonance imaging Methods 0.000 description 3
- 230000037361 pathway Effects 0.000 description 3
- 229920003023 plastic Polymers 0.000 description 3
- 239000004033 plastic Substances 0.000 description 3
- 229920002647 polyamide Polymers 0.000 description 3
- 229920001721 polyimide Polymers 0.000 description 3
- 230000009467 reduction Effects 0.000 description 3
- 230000000284 resting effect Effects 0.000 description 3
- 238000012546 transfer Methods 0.000 description 3
- 229910001369 Brass Inorganic materials 0.000 description 2
- 229910000881 Cu alloy Inorganic materials 0.000 description 2
- 239000004812 Fluorinated ethylene propylene Substances 0.000 description 2
- 229920000339 Marlex Polymers 0.000 description 2
- 239000004677 Nylon Substances 0.000 description 2
- KDLHZDBZIXYQEI-UHFFFAOYSA-N Palladium Chemical compound [Pd] KDLHZDBZIXYQEI-UHFFFAOYSA-N 0.000 description 2
- 239000004696 Poly ether ether ketone Substances 0.000 description 2
- 239000004697 Polyetherimide Substances 0.000 description 2
- 239000004698 Polyethylene Substances 0.000 description 2
- 239000004734 Polyphenylene sulfide Substances 0.000 description 2
- 239000004743 Polypropylene Substances 0.000 description 2
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 2
- 229910001080 W alloy Inorganic materials 0.000 description 2
- MTHLBYMFGWSRME-UHFFFAOYSA-N [Cr].[Co].[Mo] Chemical compound [Cr].[Co].[Mo] MTHLBYMFGWSRME-UHFFFAOYSA-N 0.000 description 2
- HZEWFHLRYVTOIW-UHFFFAOYSA-N [Ti].[Ni] Chemical compound [Ti].[Ni] HZEWFHLRYVTOIW-UHFFFAOYSA-N 0.000 description 2
- 238000004458 analytical method Methods 0.000 description 2
- 229910001566 austenite Inorganic materials 0.000 description 2
- TZCXTZWJZNENPQ-UHFFFAOYSA-L barium sulfate Chemical compound [Ba+2].[O-]S([O-])(=O)=O TZCXTZWJZNENPQ-UHFFFAOYSA-L 0.000 description 2
- 210000004369 blood Anatomy 0.000 description 2
- 239000008280 blood Substances 0.000 description 2
- 210000001772 blood platelet Anatomy 0.000 description 2
- 239000010951 brass Substances 0.000 description 2
- 230000000747 cardiac effect Effects 0.000 description 2
- 239000000788 chromium alloy Substances 0.000 description 2
- PRQRQKBNBXPISG-UHFFFAOYSA-N chromium cobalt molybdenum nickel Chemical compound [Cr].[Co].[Ni].[Mo] PRQRQKBNBXPISG-UHFFFAOYSA-N 0.000 description 2
- 239000002131 composite material Substances 0.000 description 2
- 229920001577 copolymer Polymers 0.000 description 2
- YOCUPQPZWBBYIX-UHFFFAOYSA-N copper nickel Chemical compound [Ni].[Cu] YOCUPQPZWBBYIX-UHFFFAOYSA-N 0.000 description 2
- 230000007423 decrease Effects 0.000 description 2
- 238000003745 diagnosis Methods 0.000 description 2
- 238000000113 differential scanning calorimetry Methods 0.000 description 2
- 229910000701 elgiloys (Co-Cr-Ni Alloy) Inorganic materials 0.000 description 2
- 150000002148 esters Chemical class 0.000 description 2
- 229920000840 ethylene tetrafluoroethylene copolymer Polymers 0.000 description 2
- 239000000945 filler Substances 0.000 description 2
- PCHJSUWPFVWCPO-UHFFFAOYSA-N gold Chemical compound [Au] PCHJSUWPFVWCPO-UHFFFAOYSA-N 0.000 description 2
- 229910052737 gold Inorganic materials 0.000 description 2
- 239000010931 gold Substances 0.000 description 2
- 229920001477 hydrophilic polymer Polymers 0.000 description 2
- 238000003384 imaging method Methods 0.000 description 2
- 208000017169 kidney disease Diseases 0.000 description 2
- 229910000734 martensite Inorganic materials 0.000 description 2
- 229910001092 metal group alloy Inorganic materials 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- DDTIGTPWGISMKL-UHFFFAOYSA-N molybdenum nickel Chemical compound [Ni].[Mo] DDTIGTPWGISMKL-UHFFFAOYSA-N 0.000 description 2
- 210000005036 nerve Anatomy 0.000 description 2
- 230000001537 neural effect Effects 0.000 description 2
- 229910052759 nickel Inorganic materials 0.000 description 2
- 229920001778 nylon Polymers 0.000 description 2
- 229920009441 perflouroethylene propylene Polymers 0.000 description 2
- HWLDNSXPUQTBOD-UHFFFAOYSA-N platinum-iridium alloy Chemical compound [Ir].[Pt] HWLDNSXPUQTBOD-UHFFFAOYSA-N 0.000 description 2
- 229920001200 poly(ethylene-vinyl acetate) Polymers 0.000 description 2
- 229920001707 polybutylene terephthalate Polymers 0.000 description 2
- 229920000728 polyester Polymers 0.000 description 2
- 229920002530 polyetherether ketone Polymers 0.000 description 2
- 229920001601 polyetherimide Polymers 0.000 description 2
- 229920000573 polyethylene Polymers 0.000 description 2
- 229920000139 polyethylene terephthalate Polymers 0.000 description 2
- 239000005020 polyethylene terephthalate Substances 0.000 description 2
- 239000002861 polymer material Substances 0.000 description 2
- 229920006324 polyoxymethylene Polymers 0.000 description 2
- 229920006380 polyphenylene oxide Polymers 0.000 description 2
- 229920000069 polyphenylene sulfide Polymers 0.000 description 2
- 229920001155 polypropylene Polymers 0.000 description 2
- 229920001296 polysiloxane Polymers 0.000 description 2
- 229920002635 polyurethane Polymers 0.000 description 2
- 239000004814 polyurethane Substances 0.000 description 2
- 230000001681 protective effect Effects 0.000 description 2
- 238000007674 radiofrequency ablation Methods 0.000 description 2
- 239000000523 sample Substances 0.000 description 2
- 229920000431 shape-memory polymer Polymers 0.000 description 2
- 239000011780 sodium chloride Substances 0.000 description 2
- 239000010936 titanium Substances 0.000 description 2
- 229910052719 titanium Inorganic materials 0.000 description 2
- KHXKESCWFMPTFT-UHFFFAOYSA-N 1,1,1,2,2,3,3-heptafluoro-3-(1,2,2-trifluoroethenoxy)propane Chemical compound FC(F)=C(F)OC(F)(F)C(F)(F)C(F)(F)F KHXKESCWFMPTFT-UHFFFAOYSA-N 0.000 description 1
- 206010003658 Atrial Fibrillation Diseases 0.000 description 1
- 206010003662 Atrial flutter Diseases 0.000 description 1
- 229910000014 Bismuth subcarbonate Inorganic materials 0.000 description 1
- 206010007559 Cardiac failure congestive Diseases 0.000 description 1
- 208000016216 Choristoma Diseases 0.000 description 1
- 229910000531 Co alloy Inorganic materials 0.000 description 1
- RYGMFSIKBFXOCR-UHFFFAOYSA-N Copper Chemical compound [Cu] RYGMFSIKBFXOCR-UHFFFAOYSA-N 0.000 description 1
- 229920004943 Delrin® Polymers 0.000 description 1
- 229920006055 Durethan® Polymers 0.000 description 1
- 239000004593 Epoxy Substances 0.000 description 1
- 229920000219 Ethylene vinyl alcohol Polymers 0.000 description 1
- 229910000640 Fe alloy Inorganic materials 0.000 description 1
- 229920003620 Grilon® Polymers 0.000 description 1
- 206010019280 Heart failures Diseases 0.000 description 1
- 206010020772 Hypertension Diseases 0.000 description 1
- DGAQECJNVWCQMB-PUAWFVPOSA-M Ilexoside XXIX Chemical compound C[C@@H]1CC[C@@]2(CC[C@@]3(C(=CC[C@H]4[C@]3(CC[C@@H]5[C@@]4(CC[C@@H](C5(C)C)OS(=O)(=O)[O-])C)C)[C@@H]2[C@]1(C)O)C)C(=O)O[C@H]6[C@@H]([C@H]([C@@H]([C@H](O6)CO)O)O)O.[Na+] DGAQECJNVWCQMB-PUAWFVPOSA-M 0.000 description 1
- 229920000271 Kevlar® Polymers 0.000 description 1
- JHWNWJKBPDFINM-UHFFFAOYSA-N Laurolactam Chemical compound O=C1CCCCCCCCCCCN1 JHWNWJKBPDFINM-UHFFFAOYSA-N 0.000 description 1
- 229910001209 Low-carbon steel Inorganic materials 0.000 description 1
- 229910000792 Monel Inorganic materials 0.000 description 1
- 229910000990 Ni alloy Inorganic materials 0.000 description 1
- 229920000299 Nylon 12 Polymers 0.000 description 1
- 229930040373 Paraformaldehyde Natural products 0.000 description 1
- 229910000566 Platinum-iridium alloy Inorganic materials 0.000 description 1
- 229920000265 Polyparaphenylene Polymers 0.000 description 1
- 239000004793 Polystyrene Substances 0.000 description 1
- BQCADISMDOOEFD-UHFFFAOYSA-N Silver Chemical compound [Ag] BQCADISMDOOEFD-UHFFFAOYSA-N 0.000 description 1
- QXZUUHYBWMWJHK-UHFFFAOYSA-N [Co].[Ni] Chemical compound [Co].[Ni] QXZUUHYBWMWJHK-UHFFFAOYSA-N 0.000 description 1
- 230000002159 abnormal effect Effects 0.000 description 1
- 230000004913 activation Effects 0.000 description 1
- 229920000615 alginic acid Polymers 0.000 description 1
- 235000010443 alginic acid Nutrition 0.000 description 1
- 210000001367 artery Anatomy 0.000 description 1
- 229920000249 biocompatible polymer Polymers 0.000 description 1
- 239000012620 biological material Substances 0.000 description 1
- MGLUJXPJRXTKJM-UHFFFAOYSA-L bismuth subcarbonate Chemical compound O=[Bi]OC(=O)O[Bi]=O MGLUJXPJRXTKJM-UHFFFAOYSA-L 0.000 description 1
- 229940036358 bismuth subcarbonate Drugs 0.000 description 1
- 210000000746 body region Anatomy 0.000 description 1
- 230000036760 body temperature Effects 0.000 description 1
- 210000004556 brain Anatomy 0.000 description 1
- 150000001720 carbohydrates Chemical class 0.000 description 1
- 239000000919 ceramic Substances 0.000 description 1
- OGSYQYXYGXIQFH-UHFFFAOYSA-N chromium molybdenum nickel Chemical compound [Cr].[Ni].[Mo] OGSYQYXYGXIQFH-UHFFFAOYSA-N 0.000 description 1
- 150000001875 compounds Chemical class 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 230000008602 contraction Effects 0.000 description 1
- 229910052802 copper Inorganic materials 0.000 description 1
- 239000010949 copper Substances 0.000 description 1
- 238000010790 dilution Methods 0.000 description 1
- 239000012895 dilution Substances 0.000 description 1
- 239000013013 elastic material Substances 0.000 description 1
- 229920001971 elastomer Polymers 0.000 description 1
- 239000000806 elastomer Substances 0.000 description 1
- 229920006351 engineering plastic Polymers 0.000 description 1
- JBKVHLHDHHXQEQ-UHFFFAOYSA-N epsilon-caprolactam Chemical compound O=C1CCCCCN1 JBKVHLHDHHXQEQ-UHFFFAOYSA-N 0.000 description 1
- QHSJIZLJUFMIFP-UHFFFAOYSA-N ethene;1,1,2,2-tetrafluoroethene Chemical group C=C.FC(F)=C(F)F QHSJIZLJUFMIFP-UHFFFAOYSA-N 0.000 description 1
- HQQADJVZYDDRJT-UHFFFAOYSA-N ethene;prop-1-ene Chemical group C=C.CC=C HQQADJVZYDDRJT-UHFFFAOYSA-N 0.000 description 1
- 150000002170 ethers Chemical class 0.000 description 1
- 239000005038 ethylene vinyl acetate Substances 0.000 description 1
- 239000004715 ethylene vinyl alcohol Substances 0.000 description 1
- 210000003191 femoral vein Anatomy 0.000 description 1
- 239000003302 ferromagnetic material Substances 0.000 description 1
- 229920002313 fluoropolymer Polymers 0.000 description 1
- 239000004811 fluoropolymer Substances 0.000 description 1
- 238000002594 fluoroscopy Methods 0.000 description 1
- 210000000232 gallbladder Anatomy 0.000 description 1
- 210000001035 gastrointestinal tract Anatomy 0.000 description 1
- 210000002837 heart atrium Anatomy 0.000 description 1
- 238000010438 heat treatment Methods 0.000 description 1
- RZXDTJIXPSCHCI-UHFFFAOYSA-N hexa-1,5-diene-2,5-diol Chemical compound OC(=C)CCC(O)=C RZXDTJIXPSCHCI-UHFFFAOYSA-N 0.000 description 1
- 230000002209 hydrophobic effect Effects 0.000 description 1
- 125000002768 hydroxyalkyl group Chemical group 0.000 description 1
- 238000007373 indentation Methods 0.000 description 1
- 229920000554 ionomer Polymers 0.000 description 1
- 229910052741 iridium Inorganic materials 0.000 description 1
- GKOZUEZYRPOHIO-UHFFFAOYSA-N iridium atom Chemical compound [Ir] GKOZUEZYRPOHIO-UHFFFAOYSA-N 0.000 description 1
- UGKDIUIOSMUOAW-UHFFFAOYSA-N iron nickel Chemical compound [Fe].[Ni] UGKDIUIOSMUOAW-UHFFFAOYSA-N 0.000 description 1
- 230000001788 irregular Effects 0.000 description 1
- 229920000092 linear low density polyethylene Polymers 0.000 description 1
- 239000004707 linear low-density polyethylene Substances 0.000 description 1
- 229920001684 low density polyethylene Polymers 0.000 description 1
- 239000004702 low-density polyethylene Substances 0.000 description 1
- 239000003550 marker Substances 0.000 description 1
- 230000007246 mechanism Effects 0.000 description 1
- 239000002905 metal composite material Substances 0.000 description 1
- 150000002739 metals Chemical class 0.000 description 1
- 238000012978 minimally invasive surgical procedure Methods 0.000 description 1
- 230000000116 mitigating effect Effects 0.000 description 1
- MOWMLACGTDMJRV-UHFFFAOYSA-N nickel tungsten Chemical compound [Ni].[W] MOWMLACGTDMJRV-UHFFFAOYSA-N 0.000 description 1
- 229910000623 nickel–chromium alloy Inorganic materials 0.000 description 1
- 239000012811 non-conductive material Substances 0.000 description 1
- 238000013021 overheating Methods 0.000 description 1
- 229910052763 palladium Inorganic materials 0.000 description 1
- VPRUMANMDWQMNF-UHFFFAOYSA-N phenylethane boronic acid Chemical compound OB(O)CCC1=CC=CC=C1 VPRUMANMDWQMNF-UHFFFAOYSA-N 0.000 description 1
- XNGIFLGASWRNHJ-UHFFFAOYSA-L phthalate(2-) Chemical compound [O-]C(=O)C1=CC=CC=C1C([O-])=O XNGIFLGASWRNHJ-UHFFFAOYSA-L 0.000 description 1
- 229920002492 poly(sulfone) Polymers 0.000 description 1
- 229920000412 polyarylene Polymers 0.000 description 1
- 239000004417 polycarbonate Substances 0.000 description 1
- 229920000515 polycarbonate Polymers 0.000 description 1
- 229920000570 polyether Polymers 0.000 description 1
- 239000011112 polyethylene naphthalate Substances 0.000 description 1
- 229920000098 polyolefin Polymers 0.000 description 1
- 229920002223 polystyrene Polymers 0.000 description 1
- 229920002215 polytrimethylene terephthalate Polymers 0.000 description 1
- 229920002451 polyvinyl alcohol Polymers 0.000 description 1
- 235000019422 polyvinyl alcohol Nutrition 0.000 description 1
- 239000004800 polyvinyl chloride Substances 0.000 description 1
- 239000005033 polyvinylidene chloride Substances 0.000 description 1
- 238000005381 potential energy Methods 0.000 description 1
- 230000008569 process Effects 0.000 description 1
- 238000005086 pumping Methods 0.000 description 1
- 230000033764 rhythmic process Effects 0.000 description 1
- 229910052709 silver Inorganic materials 0.000 description 1
- 239000004332 silver Substances 0.000 description 1
- 229910052708 sodium Inorganic materials 0.000 description 1
- 239000011734 sodium Substances 0.000 description 1
- 239000000758 substrate Substances 0.000 description 1
- 229910052715 tantalum Inorganic materials 0.000 description 1
- GUVRBAGPIYLISA-UHFFFAOYSA-N tantalum atom Chemical compound [Ta] GUVRBAGPIYLISA-UHFFFAOYSA-N 0.000 description 1
- MHSKRLJMQQNJNC-UHFFFAOYSA-N terephthalamide Chemical compound NC(=O)C1=CC=C(C(N)=O)C=C1 MHSKRLJMQQNJNC-UHFFFAOYSA-N 0.000 description 1
- 125000000383 tetramethylene group Chemical group [H]C([H])([*:1])C([H])([H])C([H])([H])C([H])([H])[*:2] 0.000 description 1
- 230000001225 therapeutic effect Effects 0.000 description 1
- 238000002560 therapeutic procedure Methods 0.000 description 1
- 238000002076 thermal analysis method Methods 0.000 description 1
- WFKWXMTUELFFGS-UHFFFAOYSA-N tungsten Chemical compound [W] WFKWXMTUELFFGS-UHFFFAOYSA-N 0.000 description 1
- 229910052721 tungsten Inorganic materials 0.000 description 1
- 239000010937 tungsten Substances 0.000 description 1
- 210000004291 uterus Anatomy 0.000 description 1
- 230000002792 vascular Effects 0.000 description 1
- 210000005166 vasculature Anatomy 0.000 description 1
- 210000003462 vein Anatomy 0.000 description 1
- 206010047302 ventricular tachycardia Diseases 0.000 description 1
- 230000000007 visual effect Effects 0.000 description 1
- 238000012800 visualization Methods 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00039—Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00039—Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
- A61B2017/00044—Sensing electrocardiography, i.e. ECG
- A61B2017/00048—Spectral analysis
- A61B2017/00053—Mapping
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
- A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
- A61B2018/00029—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00791—Temperature
- A61B2018/00821—Temperature measured by a thermocouple
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00839—Bioelectrical parameters, e.g. ECG, EEG
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
- A61B2218/002—Irrigation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
- A61M2025/0073—Tip designed for influencing the flow or the flow velocity of the fluid, e.g. inserts for twisted or vortex flow
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
- A61M25/007—Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
Definitions
- the present disclosure pertains to medical devices. More particularly, the present disclosure pertains to systems, devices and methods related to open-irrigated catheters used to perform ablation functions.
- Aberrant conductive pathways disrupt the normal path of the heart's electrical impulses.
- conduction blocks can cause the electrical impulse to degenerate into several circular wavelets that disrupt the normal activation of the atria or ventricles.
- the aberrant conductive pathways create abnormal, irregular, and sometimes life-threatening heart rhythms called arrhythmias.
- Ablation is one way of treating arrhythmias and restoring normal contraction.
- the sources of the aberrant pathways (called focal arrhythmia substrates) are located or mapped using mapping electrodes situated in a desired location. After mapping, the physician may ablate the aberrant tissue.
- RF radio frequency
- a cooling fluid such as a saline solution
- the cooling fluid cools the ablation electrode and surrounding tissue, thus reducing the likelihood of a thrombus, preventing or reducing impedance rise of tissue in contact with the electrode tip, and increasing energy transfer to the tissue because of the lower tissue impedance.
- An example medical device may include an open-irrigated ablation catheter system.
- the open-irrigated catheter system may include a catheter body, an electrode tip body, a proximal insert, and a fluid diverting member.
- the electrode tip body may have a distal end and a proximal end configured for connection to the catheter body.
- the electrode tip body may have a wall defining an open interior region, and the wall may have one or more irrigation port in fluid communication with the open interior region.
- the wall may be conductive for delivering radio frequency (RF) energy.
- the proximal insert may be positioned at least partially within the proximal end of the electrode tip body, and may define at least one lumen extending therethrough.
- the fluid diverting member may be spaced from a distal end of the lumen and may extend across at least a portion of the lumen such that at least a portion of fluid flowing distally through the lumen impacts the fluid diverting member and is diverted towards the wall before flowing into the interior region and out through the one or more irrigation port.
- the open-irrigated catheter system may further include a distal insert positioned within the electrode tip body that separates the open interior region into a distal fluid chamber and a proximal fluid chamber.
- the distal insert may have an opening fluidly connecting the distal and proximal fluid chambers such that at least one irrigation port is in fluid communication with the distal fluid chamber.
- Another example ablation catheter system may include a catheter body including a proximal portion and a distal portion defining a distal end and a lumen extending therethrough, and an electrode tip body having a wall defining an open interior region.
- the body may include a proximal portion including an open proximal end, and the proximal portion may include one or more openings extending through the wall.
- the proximal portion of the electrode tip body may be disposed within the lumen at the distal end of the catheter body such that the distal end of the catheter body extends distally of the one or more openings through the wall of the electrode tip body.
- Another example open-irrigated ablation catheter system may include a catheter body, an electrode tip body, and a proximal insert.
- the electrode tip body may have a proximal end configured for connection to the catheter body, the electrode tip body having a wall defining an open interior region and including a main body portion and a proximal portion.
- the main body portion may have one or more irrigation port in fluid communication with the open interior region, and the proximal portion may have one or more openings through the wall, wherein the wall is conductive for delivering radio frequency (RF) energy.
- the proximal insert may be positioned at least partially within the proximal end of the electrode tip body, and may include a proximal lip and a main body portion.
- the main body portion may have a diameter less than a diameter of the proximal lip, and may include at least one lumen extending therethrough.
- the proximal insert may include one or more openings through a sidewall in the main body portion in fluid communication with the at least one lumen.
- the main body portion of the proximal insert may be sized to be mounted within the proximal portion of the electrode tip body with the proximal lip extending radially beyond the electrode tip body, substantially aligning the openings in the proximal insert and the openings in the proximal portion of the electrode tip body.
- the proximal lip may be sized to engage an inner surface of a distal portion of the catheter body and define a space between an outer surface of the proximal portion of the electrode tip body and the inner surface of the catheter body such that a portion of cooling fluid flowing through the at least one lumen passes through the openings in the proximal insert and the openings in the proximal portion of the electrode tip body and into the space between the catheter body and the electrode tip body, thereby cooling a region where the catheter body joins the electrode tip body.
- the catheter system may further include a crown element configured to fit over the proximal end of the electrode tip body.
- the crown element may have one or more spaced apart legs configured to be disposed between the openings through the wall of the proximal portion of the electrode tip body, the crown directing fluid flow from the openings in the proximal portion toward the distal end of the catheter body.
- the catheter system may further include a fluid diverting member spaced from a distal end of a fluid lumen extending through the catheter, the fluid diverting member extending across at least a portion of the lumen such that at least a portion of fluid flowing distally through the lumen impacts the fluid diverting member and is diverted towards the wall of the electrode tip body before flowing into the interior region and out through the irrigation ports.
- Figure 1 is a perspective view of the distal end of an open-irrigated catheter according to an embodiment of the present subject matter.
- Figure 2 is a perspective view of the electrode tip body of Figure 1.
- Figure 3 is a perspective view of the proximal insert of Figure 1.
- Figure 4A is a top perspective view of the distal insert of Figure 1.
- Figure 4B is a bottom perspective view of the distal insert of Figure 1.
- Figure 5 is a perspective view of an open-irrigated catheter according to another embodiment of the present subject matter.
- Figure 6A is a side cross-sectional view of the electrode tip body and proximal insert of Figure 5.
- Figure 6B is a perspective view of the electrode tip body of Figure 5.
- Figure 7A is a top perspective view of the proximal insert of Figure 5.
- Figure 7B is a bottom perspective view of the proximal insert of Figure 5.
- Figure 8A is a top perspective view of the distal insert of Figure 5.
- Figure 8B is a bottom perspective view of the distal insert of Figure 5.
- Figure 9A is a perspective view of a crown according to an embodiment of the present subject matter.
- Figure 9B is a side view of the electrode tip body of Figure 5 with the crown of Figure 9A.
- Figure 10 is a perspective view of an open-irrigated catheter according to another embodiment of the present subject matter.
- Figure 11 is a side view of the open-irrigated catheter of Figure 10.
- Figure 12 is a side view of the electrode tip body of Figure 10.
- Figure 13 is a perspective view of an open-irrigated catheter according to another embodiment of the present subject matter.
- Figure 14 is a side view of the open-irrigated catheter of Figure 13.
- Figure 15A is a perspective top view of the proximal insert of Figure 13.
- Figure 15B is a perspective bottom view of the proximal insert of Figure 13.
- Figure 16 is a side view of the electrode tip body of Figure 13.
- Figure 17A is a top perspective view of the distal insert of Figure 13.
- Figure 17B is a bottom perspective view of the distal insert of Figure 13.
- the catheter may be referred to as a hybrid catheter as it can be used simultaneously for both localized mapping and ablation functions.
- the hybrid catheter is configured to provide localized, high resolution ECG signals during ablation.
- the localized mapping enables the mapping to be more precise than that which can be achieved with conventional ablation catheters.
- the hybrid catheter has an open-irrigated catheter design.
- a cooling fluid such as a saline, is delivered through the catheter to the catheter tip, where the fluid exits through irrigation ports to cool the electrode and surrounding tissue.
- Clinical benefits of such a catheter include, but are not limited to, controlling the temperature and reducing coagulum formation on the tip of the catheter, preventing impedance rise of tissue in contact with the catheter tip, and maximizing potential energy transfer to the tissue. Additionally, the localized intra cardiac electrical activity can be recorded in real time or near-real time right at the point of energy delivery.
- the some embodiments may be used within body lumens, chambers or cavities for diagnostic or therapeutic purposes in those instances where access to interior bodily regions is obtained through, for example, the vascular system or alimentary canal and/or with minimally invasive surgical procedures.
- some embodiments have application in the diagnosis and treatment of arrhythmia conditions within the heart.
- Some embodiments also have application in the diagnosis or treatment of ailments of the gastrointestinal tract, prostrate, brain, gall bladder, uterus, and other regions of the body.
- some embodiments can be used to create lesions to treat atrial fibrillation, atrial flutter and ventricular tachycardia.
- some embodiments can be used to modulate, block, or ablate nerve bodies in the treatment of neural structures.
- some embodiments have application in the treatment of congestive heart failure, hypertension, and other cardio-renal diseases.
- cardio-renal diseases some embodiments can be used to modulate neural function of the renal nerve.
- An open- irrigated RF ablation catheter is designed to divert the initial flow of cooling fluid within the electrode to improve the uniformity of cooling.
- the risk of thrombus formation significantly decreases using diverted flow of cooling fluid to uniformly cool the electrode.
- the exemplary catheter is configured for use within the heart and, accordingly, is about 5 French to about 1 1 French (about 1.67 mm to about 3.67 mm) in diameter.
- the wall thickness of the exemplary electrode tip body may be about 0.05 mm to about 0.3 mm.
- the portion of the catheter that is inserted into the patient is typically from about 60 to 160 cm in length.
- the length and flexibility of the catheter allow the catheter to be inserted into a main vein or artery (typically the femoral vein), directed into the interior of the heart, and then manipulated such that the desired electrode(s) contact the target tissue. Fluoroscopic imaging may be used to provide the physician with a visual indication of the location of the catheter.
- Figure 1 illustrates the distal end of an open irrigated catheter system 100 including a catheter shaft 102 with a lumen 104, an electrode tip body 1 10, a proximal insert 180, a distal insert 155, and a thermocouple 190.
- the electrode tip body 1 10 is generally hollow with a closed distal end 115, an open interior region 130, and an open proximal end 120.
- the hollow electrode tip body 1 10 has a generally cylindrical shape.
- the electrode tip body 110 may include one or more openings or irrigation ports 135 and one or more openings 128 for receiving electrodes such as mapping electrodes.
- a proximal insert 180 fits into the open proximal end 120 of the electrode tip body 110.
- the proximal insert 180 includes a lumen 182 extending longitudinally therethrough.
- a lip 185 may extend radially out from the main body of the proximal insert 180, as illustrated in Figure 3.
- the lip 185 is sized to fit into the open proximal end 120 of the electrode tip body 1 10.
- a reduced circumference of the proximal insert proximal of the lip 185 provides a region for connecting the electrode tip body 1 10 to the distal end of a catheter shaft 102.
- the proximal insert 180 may have a substantially uniform exterior dimension without a lip.
- the proximal insert 180 may have any shape and dimension provided at least a portion of the proximal insert fits within the open proximal end 120 of the electrode tip body 1 10.
- Cooling fluid can be delivered through the lumen 104 of the catheter shaft 102, through the lumen 182 of the proximal insert 180 and into the open interior region 130 of the electrode tip 1 10.
- a fluid diverting member such as a plate 184 is designed to cause the cooling fluid to be diverted towards the wall 125 at the proximal end 120 of the electrode tip body 110, where hot spots may otherwise develop.
- the plate 184 is spaced from the distal end of the proximal insert 180 and may be attached to the proximal insert 180 with one or more legs 186 or other structure.
- the plate 184 may be attached to the wall 125 of the electrode tip body 110 with one or more legs such that openings allow fluid to pass from the distal end 183 of the lumen 182 into the open interior region 130 of the electrode tip body 1 10.
- the plate 184 may extend transverse to the longitudinal axis 10 of the proximal insert 180.
- the upper surface of the plate 184 may be angled or canted relative to the longitudinal axis 10.
- the plate 184 may cover the distal end 183 of the lumen 182, such that fluid flowing distally through the lumen 182 impacts the plate 184 and is redirected towards the wall 125 of the electrode tip body 1 10.
- the redirected flow of cooling fluid provides cooling of the proximal end 120 of the electrode tip body 110 as the fluid flows across the plate 184 and between the plate 184 and wall 125 into the open interior region 130 of the electrode tip body 1 10.
- the plate 184 may have an opening 188 for receiving the thermocouple 190.
- the plate 184 may have a shape generally matching the shape of the electrode tip body.
- the electrode tip body 110 may be generally cylindrical and the plate may be circular.
- the plate may have a different shape than the electrode tip body.
- the electrode tip body may be cylindrical and the plate may be square, octagonal, oval, or have any other shape.
- the plate may be sized to extend beyond the outer edge of the lumen 182 but not to the electrode tip wall 125.
- the distance between the edge of the plate 184 and the electrode tip wall 125 may be selected to achieve a desired amount of circulating cooling fluid proximal of the plate 184, near the distal end of the catheter body and the proximal end of the electrode tip body.
- the plate may have one or more openings (not shown) to allow fluid to flow through the plate as well as around it.
- the plate 184 may extend to the wall 125 of the electrode tip body when openings are present in the plate.
- the plate 184 may have any thickness and may have a flat proximal surface 189 or may have surface irregularities and/or angles that further disrupt fluid flow.
- the plate may have a wavy, ridged, and/or grooved proximal surface, and/or the plate may have protrusions and/or indentations on the proximal surface (not shown).
- the distal surface of the plate may have the same surface characteristics as the proximal surface or the two surfaces may have different surface characteristics.
- a distal insert 155 divides the open interior region 130 of the electrode tip body 1 10 into a distal fluid reservoir 160 and a proximal fluid reservoir 165, each of which act as cooling chambers.
- the distal insert 155 may be a thermal mass.
- the distal insert 155 has an opening 170 extending from a proximal surface 162 of the distal insert to a distal surface 164.
- the opening 170 fluidly connects the distal fluid reservoir 160 and the proximal fluid reservoir 165, allowing cooling fluid to flow therethrough.
- One or more irrigation ports 135 through the wall 125 of the electrode tip body 1 10 near the distal end 1 15 allows cooling fluid to exit the device and cool the tip and surrounding tissues.
- the irrigation ports 135 may be equally spaced around the circumference of the electrode tip body. However, the present subject matter is not limited to equally-spaced irrigation ports or to a particular number of irrigation ports.
- the system can be designed with other numbers and arrangements of irrigation ports.
- the catheter system may include a temperature sensor mounted within the electrode tip body 1 10. In the illustrated embodiment, the temperature sensor is a thermocouple 190 that extends through the proximal insert 180, through an opening 188 in the plate 184, and through an opening 192 in the distal insert 155, allowing a distal end 191 of the thermocouple to be positioned in the distal fluid reservoir 160.
- the cooling fluid cools both the electrode tip body 110 and the tissue adjacent to the perimeter of the electrode tip body.
- the cooling fluid draws heat from the electrode tip body 1 10 (including the thermal mass distal insert 155) and reduces the temperature of the electrode.
- the presence of the plate 184, the proximal fluid reservoir 165, the distal insert 155, and distal fluid reservoir 160 augments the fluid cooling because the fluid flows along the wall 125 and into the proximal fluid reservoir 165 where it circulates prior to entering the distal fluid reservoir 160, where the fluid again circulates prior to exiting the electrode tip body 110 by way of the irrigation ports 135.
- the decrease in electrode and tissue temperature reduces the likelihood that the tissue in contact with the electrode tip body 1 10 will char and/or that coagulum will form on the surface of the electrode tip body.
- the amount of energy supplied to the tissue may be increased, and the energy is transferred to the tissue more efficiently, as compared to an electrode that is not configured for fluid cooling. This results in the formation of larger and deeper lesions.
- fluid that exits the electrode tip body sweeps biological material such as blood and tissue away from the electrode, further reducing the likelihood of coagulum formation.
- the plate 184, the proximal and distal fluid reservoirs 165, 160, respectively, the opening 170 in the distal insert, and the irrigation ports 135 are designed with appropriate dimensions and geometry with respect to each other to encourage turbulent fluid flow when pressurized cooling fluid flows out of the catheter body, through the proximal insert lumen 182, through the proximal fluid reservoir 165, through the opening 170 in the distal insert, through the distal fluid reservoir 160, and out the irrigation ports 135. Coolant is pumped at high pressure through the catheter.
- the plate 184 interrupts laminar flow, redirecting flow towards the wall 125 of the electrode tip body, where the fluid cools the proximal end 120 of the electrode tip body, mitigating overheating (edge effect).
- Fluid then flows around the plate 184 and into the proximal fluid reservoir 165, where the fluid circulates to cool the proximal portion of the electrode tip body distal of the plate 184. Laminar flow is further disturbed as the coolant is forced through opening 170 into the distal fluid reservoir 160. The turbulence increases as the coolant exits through the irrigation ports 135.
- the edges of the irrigation ports may be purposely left rough and ragged.
- the distal end 1 15 of the electrode tip body is a relatively flat wall. The combination of these factors causes the fluid exiting the irrigation ports to create turbulence around the entire electrode body, encouraging a more uniform cooling of the electrode body and the dilution of the blood in the vicinity of the ablation electrode. Additionally, the arrangement of the irrigation ports with respect to the distal fluid reservoir encourages the fluid to flow out at an angle toward the proximal end of the ablation electrode to cause the cooling fluid to flow, in a turbulent manner, at the proximal end of the electrode as well as at the distal end of the electrode.
- the catheter system 100 may include one or more mapping electrodes 175 shown in phantom in the drawings.
- the distal insert 155 illustrated in Figures 1, 4A and 4B includes openings or apertures 156 sized to receive a mapping electrode 175.
- the electrode tip wall 125 has a corresponding opening 128 in an exterior surface 126 thereof.
- the device includes three mapping electrodes 175 spaced equidistant around the electrode. Four our more mapping electrodes may also be used. These microelectrodes may be used in the mapping function to image localized intra cardiac activity.
- the device may be used to record high resolution, precise localized electrical activity, to prevent excessive heating of the ablation electrode, to allow greater delivery of power, to prevent the formation of coagulum and to provide the ability to diagnose complex ECG activity.
- the proximal surface 162 of the distal insert 155 may also include openings 158 sized to receive electrical conductors (not shown) used to provide electrical connections to the mapping electrodes 175.
- the electrical conductors for the mapping electrodes, the electrode tip body 110 and the thermocouple 190 are incorporated into the catheter construction as is generally known in the art.
- an embodiment of the distal insert is fabricated from stainless steel. Additional details concerning mapping electrodes may be found in, for example, U.S. Publication. Nos. 2008/0243214 and 2010/0331658, which are hereby incorporated by reference.
- FIG. 5 shows an electrode tip body 210 in perspective, and a catheter distal end 205 in cross section.
- the distal end of the open-irrigated catheter system 200 includes an electrode tip body 210, a proximal insert 280, a distal insert 255, and a catheter shaft 202 having a lumen 204 and a distal end 205.
- the electrode tip body 210 is generally hollow with a closed distal end 215, an open interior region 230, an open proximal end 220 and a main body 219.
- Figure 6A shows a cross-section side view of the tip body 210, the distal end 205 of the catheter shaft 202, and the proximal insert 280.
- FIG. 6B shows a perspective view of electrode tip body 210.
- the hollow electrode tip body 210 has a generally cylindrical shape with a planar distal end 215.
- the electrode tip body 210 may have a shoulder region 218 joining a smaller diameter proximal end 220 to the main body 219.
- the diameter of the main body 219 may be sized to correspond to a diameter of the distal end 205 of the catheter shaft 202.
- the electrode tip body 210 may include one or more irrigation ports 235 through the wall 225 of the electrode tip body 210 near the distal end 215. When more than one irrigation port is present, the irrigation ports 135 may be equally spaced around the circumference of the electrode tip body. However, the present subject matter is not limited to equally-spaced irrigation ports or to a particular number of irrigation ports. The system can be designed with other numbers and arrangements of irrigation ports.
- the electrode tip body 210 may also include one or more openings 228 for receiving electrodes such as mapping electrodes.
- the proximal end 220 of the electrode tip body 210 may have one or more openings 236 through the wall that allow cooling fluid to exit and cool the proximal region of the electrode tip body. If a plurality of openings are present, the openings 236 may be equally spaced around the circumference of the electrode tip body. However, the present subject matter is not limited to equally-spaced irrigation ports or to a particular number or arrangement of openings.
- a proximal insert 280 fits into the open proximal end 220 of the electrode tip body 210.
- the proximal insert 280 includes at least one fluid lumen 282 and a thermocouple opening 287 extending longitudinally therethrough.
- a proximal lip 281 extends radially out from the main body 278 of the proximal insert 280, as illustrated in Figures 5, 7A and 7B.
- the main body 278 is sized to fit into the open proximal end 220 of the electrode tip body 210 with the proximal lip 281 resting on and extending radially away from the proximal edge of the electrode tip body.
- the proximal lip 281 fits within the distal end 205 of the catheter shaft 202.
- the proximal lip 281 extending radially beyond the electrode tip body defines a space 216 between the proximal end 220 of the electrode tip body 210 and the catheter shaft 202.
- the proximal insert 280 may include openings 285 in the main body 278 allowing some cooling fluid to exit the lumen 282 and pass through openings 236 in the proximal end 220 of the electrode tip body 210.
- the openings 285 and 236 may be sized, numbered, and arranged to overlap, as illustrated in the cut-away region shown in Figure 5 and in the cross- sectional view shown in Figure 6A, or they may differ in any or all of size, number, and arrangement such that the openings 285 and 236 are offset.
- Cooling fluid as shown by the fluid flow lines 25 in Figure 5, exiting the openings 285 and 236 may circulate in the space 216 before exiting the device through a gap between the distal end 205 of the catheter shaft 202 and the shoulder region 218 of the electrode tip body 210.
- Some cooling fluid may also flow directly through the lumen 282 and into the proximal fluid reservoir 265, where it may circulate before flowing into the lumen 270 in the distal insert 255 and into the distal fluid reservoir 260, where it may again circulate before flowing out through the irrigation ports 235, as shown by the fluid flow lines 25 in FIG. 5.
- a distal insert 255 divides the open interior region 230 of the electrode tip body 210 into a distal fluid reservoir 260 and a proximal fluid reservoir 265, each of which act as cooling chambers.
- the distal insert 255 may be a thermal mass.
- an embodiment of the distal insert is fabricated from stainless steel.
- the distal insert 255 has an lumen 270 extending from a proximal surface 262 to a distal surface 264.
- the lumen 270 connects the distal fluid reservoir 260 and the proximal fluid reservoir 265.
- the distal insert 255 may include additional openings such as the opening 292 sized to receive a thermocouple.
- the catheter system 200 may include one or more mapping electrodes 275, shown in phantom lines in the figures.
- the distal insert 255 illustrated in Figures 5, 8A, and 8B includes openings or apertures 256 sized to receive a mapping electrode 275.
- the electrode tip wall 225 has a corresponding opening 228 in an exterior surface 226 thereof.
- the device includes three mapping electrodes 275 spaced equidistant around the electrode. Four our more mapping electrodes may also be used.
- the proximal surface 262 of the distal insert 255 may also include openings 258 sized to receive electrical conductors (not shown) used to provide electrical connections to the mapping electrodes 275. Electrical conduction for the mapping electrodes, the tip electrode, and the thermocouple may be incorporated into the catheter as generally known in the art.
- the catheter system 200 may include a crown 293 sized to fit over the proximal end 220 of the electrode tip body 210.
- the crown 293 includes one or more legs 294 separated by spaces 295.
- the legs 294 and spaces 295 are configured such that when the crown 293 is placed on the proximal end 220 of the electrode tip body, illustrated in Figure 9B, the legs 294 extend in a distal direction and are disposed between the openings 236 in the electrode tip body.
- the crown 293 may have a lip 296 that engages the proximal edge of the electrode tip body and maintains the crown in position.
- the crown 293 has a thickness that blocks at least a portion of the space 216 between the catheter shaft 202 and the electrode tip body 210, thereby directing fluid flow from the openings 236, 285 distally toward the shoulder region 218 and out from under the distal-most edge of the catheter shaft 202.
- Figure 10 illustrates the distal end of another open-irrigated catheter system 300 including an electrode tip body 310, a proximal insert 380, and a distal insert 355.
- the electrode tip body 310 shown in Figure 10 is similar to that shown in Figure 5, but without the openings 236.
- the electrode tip body 310 is generally hollow with a closed distal end 315, an open interior region 330, an open proximal end 320 and a main body 319.
- the hollow electrode tip body 310 has a generally cylindrical shape with a planar distal end 315.
- the electrode tip body 310 may have a shoulder region 318 joining a smaller diameter proximal end 320 to the main body 319.
- the diameter of the main body 319 may be sized to correspond to a diameter of the distal end 305 of a catheter shaft 302, providing a flush join between the catheter shaft and the electrode tip body, as illustrated in Figure 1 1.
- the electrode tip body 310 may include one or more irrigation ports 335 through the wall 325 of the electrode tip body 310 near the distal end 315. When more than one irrigation port is present, the irrigation ports 335 may be spaced and arranged around the circumference of the electrode tip body in any manner and/or pattern.
- the electrode tip body 310 may also include one or more openings 328 for receiving electrodes such as mapping electrodes.
- a proximal insert 380 fits into the open proximal end 320 of the electrode tip body 310.
- the proximal insert 380 includes at least one fluid lumen 382 and may have a thermocouple opening 387 extending longitudinally therethrough.
- a proximal lip 381 may extend radially out from the main body 378 of the proximal insert 380.
- the main body 378 is sized to fit into the open proximal end 320 of the electrode tip body 310 with the proximal lip 381 resting on the proximal edge of the electrode tip body.
- the proximal insert 380 has a length such that a distal end 317 of the proximal insert 380 resides proximal of the shoulder region 318. Cooling fluid, as shown by the fluid flow lines 25, exiting the distal end 317 of the proximal insert 380 cools the shoulder region 318 where the distal end 305 of the catheter shaft 302 meets the electrode tip body 310.
- the proximal insert may include a fluid diverting member to increase the circulation of fluid at the shoulder region 318 of the electrode tip body 310.
- a plate 184 such as that illustrated in FIG. 1 may be attached to the proximal insert 380 or the electrode tip body 310.
- a distal insert 355 divides the open interior region 330 of the electrode tip body 310 into a distal fluid reservoir 360 and a proximal fluid reservoir 365, each of which act as cooling chambers.
- the distal insert 355 may be a thermal mass.
- the distal insert 355 has an opening 370 extending from a proximal surface 362 to a distal surface 364.
- the opening 370 connects the distal fluid reservoir 360 and the proximal fluid reservoir 365.
- the distal insert 355 may include additional openings such as an opening 392 sized to receive a thermocouple (not shown).
- the catheter system 300 may include one or more mapping electrodes 375.
- the distal insert 355 may include openings or apertures 356 sized to receive mapping electrodes 375.
- the electrode tip wall 325 has a corresponding opening 328 in an exterior surface 326 thereof.
- the device includes three mapping electrodes 375 spaced equidistant around the electrode. Four our more mapping electrodes may also be used.
- the proximal surface 362 of the distal insert 355 may also include openings 358 sized to receive electrical conductors (not shown) used to provide electrical connections to the mapping electrodes 375.
- an embodiment of the distal insert is fabricated from stainless steel.
- Figure 13 illustrates the distal end of another open-irrigated catheter system 400 including a catheter shaft 402, an electrode tip body 410, a proximal insert 480, and a distal insert 455.
- the electrode tip body 410 is generally hollow with a closed distal end 415, an open interior region 430, an open proximal end 420 and a main body 419.
- the hollow electrode tip body 410 has a generally cylindrical shape with a planar distal end 415.
- the electrode tip body 410 may have a shoulder region 418 joining a smaller diameter proximal end 420 to the main body 419.
- the diameter of the main body 419 may be sized to correspond to a diameter of the distal end 405 of the catheter shaft 402, providing a flush join between the catheter shaft and the electrode tip body, as illustrated in Figure 14.
- the electrode tip body 410 may include one or more irrigation ports 435 through the wall 425 of the electrode tip body 410 near the distal end 415. When more than one irrigation port is present, the irrigation ports 435 may be spaced and arranged around the circumference of the electrode tip body in any manner and/or pattern.
- the electrode tip body 410 may also include one or more openings 428 for receiving electrodes such as mapping electrodes.
- a proximal insert 480 fits into the open proximal end 420 of the electrode tip body 410.
- the proximal insert 480 includes at least one fluid lumen 482 extending longitudinally therethrough.
- a distal reduced diameter region 479 of the proximal insert 480 is sized to fit into the open proximal end 420 of the electrode tip body 410 with the main body 478 of the proximal insert 480 resting on the proximal edge of the electrode tip body 410.
- An outer surface of the proximal insert main body 478 may be flush with an outer surface of the proximal end 420 of the electrode tip body, both of which fit within the distal end 405 of the catheter shaft 402.
- the proximal insert 480 has a length such that a distal end 417 of the proximal insert 480 resides proximal of the shoulder region 418. Cooling fluid, as shown by the fluid flow lines 25, exiting the distal end 417 of the proximal insert 480 cools the shoulder region 418 where the distal end 405 of the catheter shaft 402 meets the electrode tip body 410.
- the proximal insert may include a fluid diverting member to increase the circulation of fluid at the shoulder region 418 of the electrode tip body 410.
- a plate 184 such as that illustrated in FIG. 1 may be attached to the proximal insert 480 or the electrode tip body 410.
- a distal insert 455 divides the open interior region 430 of the electrode tip body 410 into a distal fluid reservoir 460 and a proximal fluid reservoir 465, each of which act as cooling chambers.
- the distal insert 455 may be a thermal mass.
- the distal insert 455 has an opening 470 extending from a proximal surface 462 to a distal surface 464.
- the opening 470 connects the distal fluid reservoir 460 and the proximal fluid reservoir 465.
- the distal insert 455 may include additional openings such as an opening 392 sized to receive a thermocouple (not shown).
- the catheter system 400 may include one or more mapping electrodes 475.
- the distal insert 455 may include openings or apertures 456 sized to receive mapping electrodes 475.
- the electrode tip wall 425 has corresponding openings 428 in an exterior surface 426 thereof.
- the device includes three mapping electrodes 475 spaced equidistant around the electrode. Four our more mapping electrodes may also be used.
- the proximal surface 462 of the distal insert 455 may also include openings 458 sized to receive electrical conductors (not shown) used to provide electrical connections to the mapping electrodes 375.
- an embodiment of the distal insert is fabricated from stainless steel.
- the electrode tip body may have a diameter on the order of about 0.08-0.1 inches (about 0.2032 - 0.254 cm), a length on the order of about 0.2-0.3 inches (about 0.508 - 0.762 cm), and an exterior wall with a thickness on the order of 0.003-0.004 inches (0.00762 - 0.01016 cm).
- the distal end may be planar. It should be noted that there are no holes in the distal end wall of the exemplary electrode tip body for fluid cooling and/or passage of a temperature sensor that is aligned with the outer surface of the electrode. Such holes would create regions of high current density and regions of high current density near the center of the electrode tip would work against efforts to move current to the outer perimeter of the electrode tip.
- a plurality of irrigation ports 135, 235, 335, 435 or exit ports are shown near the distal end of the electrode tip body 1 10, 210, 310, 410 in Figures 1, 5, 10, and 13.
- an embodiment has irrigation ports with a diameter approximately within a range of 0.01 to 0.02 inches (0.0254 to 0.0508 cm).
- Fluid such as a saline solution, flows from the distal fluid reservoir, through these ports to the exterior of the catheter. This fluid is used to cool the ablation electrode tip body and the tissue near the electrode. This temperature control reduces coagulum formation on the tip of the catheter, prevents impedance rise of tissue in contact with the catheter tip, and increases energy transfer to the tissue because of the lower tissue impedance.
- the exemplary electrode tip bodies may be formed from any suitable electrically conductive material.
- suitable materials for the main portion of the electrode tip body, i.e. the side wall and planar distal end include silver, platinum, gold, stainless steel, plated brass, platinum iridium and combinations thereof.
- some embodiments use a platinum-iridium alloy.
- Some embodiments use an alloy with approximately 90% platinum and 10% iridium.
- This conductive material is used to conduct RF energy used to form legions during the ablation procedure.
- the reduction in diameter may be achieved by swaging.
- separate pieces of differing diameter may be laser welded or soldered together to form the electrode tip body.
- the distal insert may be a thermal mass formed from any suitable electrically and thermally conducting material such as, for example, brass, copper and stainless.
- the distal insert may, alternatively, be made of thermally conducting and electrically non-conducing materials.
- the proximal insert may be mounted within the proximal region of the electrode tip body.
- the proximal insert may be formed from an electrically conductive material such as stainless steel, or an electrically non-conductive material such as nylon or polyimide.
- the proximal insert may include any number of lumens for fluid flow and for receiving a thermocouple, steering element, electrical conductor, or other element. Alternatively, a fluid conduit may be placed within one of the lumens.
- a steering center support may be positioned within a lumen and be secured to the proximal insert.
- the catheter systems 100, 200, 300, 400 are part of a mapping and ablation system that includes an open-irrigated catheter.
- the systems 100, 200, 300, 400 include an ablation electrode tip body 1 10, 210, 310, 410 with mapping electrodes 175 and irrigation ports 135, 235, 335, 435.
- the catheter may be functionally divided into four regions: the operative distal probe assembly region (e.g. the distal portion of catheter shaft 102, 202, 302, 402), a main catheter region (not shown), a deflectable catheter region (not shown), and a proximal catheter handle region (not shown) where a handle assembly (not shown) is attached.
- the catheter body includes a coolant flow path or conduit and may include other tubular element(s) to provide the desired functionality to the catheter.
- the addition of metal in the form of a braided mesh layer (not shown) sandwiched in between layers of plastic tubing may be used to increase the rotational stiffness of the catheter.
- a deflectable catheter region allows the catheter to be steered through the vasculature of the patient and allows the probe assembly to be accurately placed adjacent the targeted tissue region.
- a steering wire (not shown) may be slidably disposed within the catheter body.
- a handle assembly (not shown) may include a steering member such as a rotating steering knob that is rotatably mounted to the handle.
- Rotational movement of the steering knob relative to the handle in a first direction may cause a steering wire to move proximally relative to the catheter body which, in turn, tensions the steering wire, thus pulling and bending the catheter deflectable region into an arc; and rotational movement of the steering knob relative to the handle in a second direction may cause the steering wire to move distally relative to the catheter body which, in turn, relaxes the steering wire, thus allowing the catheter to return toward its form.
- the deflectable catheter region may be made of a lower durometer plastic than the main catheter region.
- the system may include an RF generator (not shown) used to generate the energy for the ablation procedure.
- An RF generator may include a source for the RF energy and a controller for controlling the timing and the level of the RF energy delivered through the electrode tip body.
- the system may include a fluid reservoir and pump (not shown) for pumping cooling fluid, such as a saline, through the catheter and out through the irrigation ports.
- a mapping signal processor (not shown) may be connected to the mapping electrodes. The mapping signal processor and mapping electrodes detect electrical activity of the heart. This electrical activity is evaluated to analyze an arrhythmia and to determine where to deliver the ablation energy as a therapy for the arrhythmia.
- modules and other circuitry shown and described herein can be implemented using software, hardware, and/or firmware.
- Various disclosed methods may be implemented as a set of instructions contained on a computer-accessible medium capable of directing a processor to perform the respective method. Additional details concerning this type of catheter system may be found in, for example, U.S. Publication. Nos. 2008/0243214, 2009/0093810, 2010/0331658, and 2011/0009857, which are hereby incorporated by reference.
- the exemplary catheter systems 100, 200, 300 400 illustrated in Figures 1, 5, 10, and 13 may be provided with a conventional steering mechanism.
- the catheter may include a steering wire (not shown) slidably disposed within the catheter body, or a steering center support and steering wire arrangement (not shown).
- a steering center support with a pair of adjacent steering wires may extend through the catheter body to a handle (not shown), which is also configured for steering. Additional details concerning this type of steering arrangement may be found in, for example, U.S. Pat. Nos. 5,871,525 and 6,287,301, which are hereby incorporated by reference.
- Other suitable steering arrangements are disclosed in U.S. Pat. Nos. 6,013,052 and 6,287,301, which are hereby incorporated by reference.
- the present inventions are not limited to steerable catheter apparatus, or to any particular type of steering arrangement in those catheter apparatus which are steerable.
- the materials that can be used for the various components of the open-irrigated ablation catheters disclosed herein may vary. For simplicity purposes, the following discussion makes reference to the catheter body. However, this is not intended to limit the devices and methods described herein, as the discussion may be applied to other similar tubular members and/or components of tubular members or devices disclosed herein.
- the various components of the system, such as the electrode tip, proximal insert, and fluid diverting member may be a single monolithic structure or separate elements.
- Catheter body and/or other components of catheter system may be made from a metal, metal alloy, polymer (some examples of which are disclosed below), a shape memory polymer, a metal-polymer composite, ceramics, other composites, combinations thereof, and the like, or other suitable material.
- suitable metals and metal alloys include stainless steel, such as 304V, 304L, and 316LV stainless steel; mild steel; nickel-titanium alloy such as linear-elastic and/or super-elastic nitinol; other nickel alloys such as nickel-chromium-molybdenum alloys (e.g., UNS: N06625 such as I CONEL® 625, UNS: N06022 such as HASTELLOY® C-22®, UNS: N10276 such as HASTELLOY® C276®, other HASTELLOY® alloys, and the like), nickel-copper alloys (e.g., UNS: N04400 such as MONEL® 400, NICKELVAC® 400, NICORROS® 400, and the like), nickel-cobalt-chromium- molybdenum alloys (e.g., UNS: R30035 such as MP35-N® and the like), nickel- molybdenum alloys (e.g.,
- Linear elastic and/or non-super-elastic nitinol may be distinguished from super elastic nitinol in that the linear elastic and/or non-super-elastic nitinol does not display a substantial "superelastic plateau” or “flag region” in its stress/strain curve like super elastic nitinol does.
- linear elastic and/or non-super-elastic nitinol as recoverable strain increases, the stress continues to increase in a substantially linear, or a somewhat, but not necessarily entirely linear relationship until plastic deformation begins or at least in a relationship that is more linear that the super elastic plateau and/or flag region that may be seen with super elastic nitinol.
- linear elastic and/or non-super-elastic nitinol may also be termed "substantially" linear elastic and/or non-super-elastic nitinol.
- linear elastic and/or non-super-elastic nitinol may also be distinguishable from super elastic nitinol in that linear elastic and/or non-super-elastic nitinol may accept up to about 2-5% strain while remaining substantially elastic (e.g., before plastically deforming) whereas super elastic nitinol may accept up to about 8% strain before plastically deforming. Both of these materials can be distinguished from other linear elastic materials such as stainless steel (that can also can be distinguished based on its composition), which may accept only about 0.2 to 0.44 percent strain before plastically deforming.
- the linear elastic and/or non-super-elastic nickel- titanium alloy is an alloy that does not show any martens ite/austenite phase changes that are detectable by differential scanning calorimetry (DSC) and dynamic metal thermal analysis (DMTA) analysis over a large temperature range.
- DSC differential scanning calorimetry
- DMTA dynamic metal thermal analysis
- the mechanical bending properties of such material may therefore be generally inert to the effect of temperature over this very broad range of temperature.
- the mechanical bending properties of the linear elastic and/or non-super-elastic nickel- titanium alloy at ambient or room temperature are substantially the same as the mechanical properties at body temperature, for example, in that they do not display a super-elastic plateau and/or flag region.
- the linear elastic and/or non-super-elastic nickel-titanium alloy maintains its linear elastic and/or non-super-elastic characteristics and/or properties.
- the linear elastic and/or non-super-elastic nickel- titanium alloy may be in the range of about 50 to about 60 weight percent nickel, with the remainder being essentially titanium. In some embodiments, the composition is in the range of about 54 to about 57 weight percent nickel.
- a suitable nickel-titanium alloy is FHP-NT alloy commercially available from Furukawa Techno Material Co. of Kanagawa, Japan. Some examples of nickel titanium alloys are disclosed in U.S. Patent Nos. 5,238,004 and 6,508,803, which are incorporated herein by reference. Other suitable materials may include ULTANIUMTM (available from Neo-Metrics) and GUM METALTM (available from Toyota).
- a superelastic alloy for example a superelastic nitinol can be used to achieve desired properties.
- Shape memory polymer materials may also be used for catheter body.
- portions or all of catheter body may also be loaded with, made of, or otherwise include a radiopaque material.
- Radiopaque materials are understood to be materials capable of producing a relatively bright image on a fluoroscopy screen or another imaging technique during a medical procedure. This relatively bright image aids the user of catheter system in determining its location.
- Some examples of radiopaque materials can include, but are not limited to, gold, platinum, palladium, tantalum, tungsten alloy, polymer material loaded with a radiopaque filler (e.g., barium sulfate, bismuth subcarbonate, etc.), and the like. Additionally, other radiopaque marker bands and/or coils may also be incorporated into the design of catheter system 100 to achieve the same result.
- catheter body may be made of a material that does not substantially distort the image and create substantial artifacts (i.e., gaps in the image). Certain ferromagnetic materials, for example, may not be suitable because they may create artifacts in an MRI image.
- the catheter body, or portions thereof, may also be made from a material that the MRI machine can image.
- Some materials that exhibit these characteristics include, for example, tungsten, cobalt-chromium-molybdenum alloys (e.g., U S: R30003 such as ELGILOY®, PHY OX®, and the like), nickel-cobalt-chromium-molybdenum alloys (e.g., UNS: R30035 such as MP35-N® and the like), nitinol, and the like, and others.
- cobalt-chromium-molybdenum alloys e.g., U S: R30003 such as ELGILOY®, PHY OX®, and the like
- nickel-cobalt-chromium-molybdenum alloys e.g., UNS: R30035 such as MP35-N® and the like
- nitinol and the like, and others.
- a sheath or covering may be disposed over portions or all of the catheter body that may define a generally smooth outer surface for the catheter system. In other embodiments, however, such a sheath or covering may be absent from a portion of all of the catheter system.
- the sheath may be made from a polymer or other suitable material.
- suitable polymers may include polytetrafluoroethylene (PTFE), ethylene tetrafluoroethylene (ETFE), fluorinated ethylene propylene (FEP), polyoxymethylene (POM, for example, DELRIN® available from DuPont), polyether block ester, polyurethane (for example, Polyurethane 85A), polypropylene (PP), polyvinylchloride (PVC), polyether-ester (for example, ARNITEL® available from DSM Engineering Plastics), ether or ester based copolymers (for example, butylene/poly(alkylene ether) phthalate and/or other polyester elastomers such as HYTREL® available from DuPont), polyamide (for example, DURETHAN® available from Bayer or CRISTAMID® available from Elf Atochem), elastomeric polyamides, block polyamide/ethers, polyether block amide (PEBA, for example available under the trade name PEBAX®), ethylene vinyl acetate
- the exterior surface of the catheter system may be sandblasted, beadblasted, sodium bicarbonate-blasted, electropolished, etc.
- a coating for example a lubricious, a hydrophilic, a protective, or other type of coating may be applied over portions or all of the sheath, or in embodiments without a sheath over portions of the catheter system.
- the sheath may comprise a lubricious, hydrophilic, protective, or other type of coating.
- Hydrophobic coatings such as fluoropolymers provide a dry lubricity which improves guidewire handling and device exchanges. Lubricious coatings improve steerability and improve lesion crossing capability.
- Suitable lubricious polymers are well known in the art and may include silicone and the like, hydrophilic polymers such as high-density polyethylene (HDPE), polytetrafluoroethylene (PTFE), polyarylene oxides, polyvinylpyrolidones, polyvinylalcohols, hydroxy alkyl cellulosics, algins, saccharides, caprolactones, and the like, and mixtures and combinations thereof. Hydrophilic polymers may be blended among themselves or with formulated amounts of water insoluble compounds (including some polymers) to yield coatings with suitable lubricity, bonding, and solubility. Some other examples of such coatings and materials and methods used to create such coatings can be found in U.S. Patent Nos. 6, 139,510 and 5,772,609, which are incorporated herein by reference.
- the coating and/or sheath may be formed, for example, by coating, extrusion, co-extrusion, interrupted layer co-extrusion (ILC), or fusing several segments end-to- end.
- the layer may have a uniform stiffness or a gradual reduction in stiffness from the proximal end to the distal end thereof. The gradual reduction in stiffness may be continuous as by ILC or may be stepped as by fusing together separate extruded tubular segments.
- the outer layer may be impregnated with a radiopaque filler material to facilitate radiographic visualization. Those skilled in the art will recognize that these materials can vary widely without deviating from the scope of the present invention.
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Otolaryngology (AREA)
- Veterinary Medicine (AREA)
- Physics & Mathematics (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Plasma & Fusion (AREA)
- Surgical Instruments (AREA)
- Electromagnetism (AREA)
Abstract
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201361793649P | 2013-03-15 | 2013-03-15 | |
PCT/US2014/026602 WO2014151876A1 (fr) | 2013-03-15 | 2014-03-13 | Cathéter d'ablation à irrigation ouverte ayant un refroidissement proximal |
Publications (2)
Publication Number | Publication Date |
---|---|
EP2967731A1 true EP2967731A1 (fr) | 2016-01-20 |
EP2967731B1 EP2967731B1 (fr) | 2020-10-07 |
Family
ID=50440869
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP14715792.9A Active EP2967731B1 (fr) | 2013-03-15 | 2014-03-13 | Cathéter d'ablation à irrigation ouverte ayant un refroidissement proximal |
Country Status (5)
Country | Link |
---|---|
US (1) | US9615879B2 (fr) |
EP (1) | EP2967731B1 (fr) |
JP (1) | JP6235116B2 (fr) |
CN (1) | CN105188588B (fr) |
WO (1) | WO2014151876A1 (fr) |
Families Citing this family (23)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10695126B2 (en) | 2008-10-06 | 2020-06-30 | Santa Anna Tech Llc | Catheter with a double balloon structure to generate and apply a heated ablative zone to tissue |
TWI460054B (zh) * | 2012-07-05 | 2014-11-11 | Infar Ind Co Ltd | 防潰角開口快轉扳手 |
TWI468260B (zh) * | 2012-08-07 | 2015-01-11 | Infar Ind Co Ltd | 防潰角開口快轉扳手(二) |
WO2014151876A1 (fr) | 2013-03-15 | 2014-09-25 | Boston Scientific Scimed, Inc. | Cathéter d'ablation à irrigation ouverte ayant un refroidissement proximal |
CN105050523B (zh) | 2013-03-15 | 2017-11-10 | 波士顿科学医学有限公司 | 开放式灌注消融导管 |
US10016234B2 (en) * | 2014-06-05 | 2018-07-10 | St. Jude Medical, Cardiology Division, Inc. | Flex tip fluid lumen assembly with thermal sensor |
KR20170107428A (ko) * | 2014-11-19 | 2017-09-25 | 어드밴스드 카디악 테라퓨틱스, 인크. | 고분해능 전극 어셈블리를 이용한 절제 장치, 시스템 및 방법 |
JP6673598B2 (ja) * | 2014-11-19 | 2020-03-25 | エピックス セラピューティクス,インコーポレイテッド | ペーシングを伴う組織の高分解能マッピング |
US9724154B2 (en) | 2014-11-24 | 2017-08-08 | Biosense Webster (Israel) Ltd. | Irrigated ablation catheter with multiple sensors |
JP2018524054A (ja) * | 2015-06-03 | 2018-08-30 | セント・ジュード・メディカル・インターナショナル・ホールディング・エスエーアールエルSt. Jude Medical International Holding S.a,r.l. | 能動型磁気位置センサ |
CN107750146A (zh) * | 2015-06-29 | 2018-03-02 | 波士顿科学医学有限公司 | 开放冲洗消融导管 |
DE102015215755A1 (de) * | 2015-08-18 | 2017-02-23 | Olympus Winter & Ibe Gmbh | Elektrochirurgisches Instrument und Verfahren zum Betreiben |
US11331140B2 (en) | 2016-05-19 | 2022-05-17 | Aqua Heart, Inc. | Heated vapor ablation systems and methods for treating cardiac conditions |
US11911093B2 (en) | 2016-09-12 | 2024-02-27 | Biosense Webster (Israel) Ltd. | Irrigation system for a catheter |
JP7049326B2 (ja) | 2016-10-04 | 2022-04-06 | アヴェント インコーポレイテッド | 冷却型rfプローブ |
US11020174B2 (en) * | 2016-10-17 | 2021-06-01 | Biosense Webster (Israel) Ltd. | Catheter with angled irrigation holes |
CN110087571B (zh) * | 2016-12-19 | 2022-04-12 | 波士顿科学医学有限公司 | 具有近端插入件冷却的开放式冲洗消融导管 |
US11801364B2 (en) * | 2017-06-30 | 2023-10-31 | Avectas Limited | Electrospray catheter |
US11284939B2 (en) * | 2017-07-06 | 2022-03-29 | Biosense Webster (Israel) Ltd. | Irrigated catheter with improved ablation tip electrode fluid distribution |
US20190374282A1 (en) * | 2018-06-08 | 2019-12-12 | St. Jude Medical International Holding S.À R.L. | One fiber force and shape sensing |
CA3105282A1 (fr) | 2018-08-22 | 2020-02-27 | Ran Sela | Recipient de transducteur ultrasonore de catheter |
WO2020208587A1 (fr) * | 2019-04-10 | 2020-10-15 | St. Jude Medical International Holding S.À R.L. | Pointe de cathéter d'ablation avec circuit électronique flexible |
JP7465632B2 (ja) | 2019-05-14 | 2024-04-11 | Nok株式会社 | 密封装置 |
Family Cites Families (72)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4636313A (en) | 1984-02-03 | 1987-01-13 | Vaillancourt Vincent L | Flexible filter disposed within flexible conductor |
US5238004A (en) | 1990-04-10 | 1993-08-24 | Boston Scientific Corporation | High elongation linear elastic guidewire |
WO1993020768A1 (fr) | 1992-04-13 | 1993-10-28 | Ep Technologies, Inc. | Ensemble antenne micro-ondes orientable pour l'ablation de tissus dans le c×ur |
DE4338758C2 (de) | 1992-11-13 | 2001-08-09 | Scimed Life Systems Inc | Katheteranordnung |
US5545161A (en) | 1992-12-01 | 1996-08-13 | Cardiac Pathways Corporation | Catheter for RF ablation having cooled electrode with electrically insulated sleeve |
US5772609A (en) | 1993-05-11 | 1998-06-30 | Target Therapeutics, Inc. | Guidewire with variable flexibility due to polymeric coatings |
US5437282A (en) | 1993-10-29 | 1995-08-01 | Boston Scientific Corporation | Drive shaft for acoustic imaging catheters and flexible catheters |
US5458597A (en) * | 1993-11-08 | 1995-10-17 | Zomed International | Device for treating cancer and non-malignant tumors and methods |
US5462521A (en) | 1993-12-21 | 1995-10-31 | Angeion Corporation | Fluid cooled and perfused tip for a catheter |
US5413107A (en) | 1994-02-16 | 1995-05-09 | Tetrad Corporation | Ultrasonic probe having articulated structure and rotatable transducer head |
US6139510A (en) | 1994-05-11 | 2000-10-31 | Target Therapeutics Inc. | Super elastic alloy guidewire |
US6053912A (en) | 1995-05-01 | 2000-04-25 | Ep Techonologies, Inc. | Systems and methods for sensing sub-surface temperatures in body tissue during ablation with actively cooled electrodes |
US5688267A (en) | 1995-05-01 | 1997-11-18 | Ep Technologies, Inc. | Systems and methods for sensing multiple temperature conditions during tissue ablation |
US5895355A (en) | 1995-05-23 | 1999-04-20 | Cardima, Inc. | Over-the-wire EP catheter |
US5782760A (en) | 1995-05-23 | 1998-07-21 | Cardima, Inc. | Over-the-wire EP catheter |
US5779699A (en) | 1996-03-29 | 1998-07-14 | Medtronic, Inc. | Slip resistant field focusing ablation catheter electrode |
AU8507698A (en) | 1997-07-29 | 1999-02-22 | Ep Technologies Inc | Improved catheter distal end assemblies |
US6013052A (en) | 1997-09-04 | 2000-01-11 | Ep Technologies, Inc. | Catheter and piston-type actuation device for use with same |
US6120476A (en) | 1997-12-01 | 2000-09-19 | Cordis Webster, Inc. | Irrigated tip catheter |
DE19982467T1 (de) | 1998-11-06 | 2001-02-22 | Furukawa Electric Co Ltd | Auf NiTi basierender medizinischer Führungsdraht und Verfahren zur Herstellung desselben |
US20030009094A1 (en) * | 2000-11-15 | 2003-01-09 | Segner Garland L. | Electrophysiology catheter |
US6611699B2 (en) | 2001-06-28 | 2003-08-26 | Scimed Life Systems, Inc. | Catheter with an irrigated composite tip electrode |
US20050203410A1 (en) | 2004-02-27 | 2005-09-15 | Ep Medsystems, Inc. | Methods and systems for ultrasound imaging of the heart from the pericardium |
US7887558B2 (en) | 2004-09-28 | 2011-02-15 | Maquet Cardiovascular Llc | Modular vessel harvesting system and method |
KR100640283B1 (ko) | 2004-12-28 | 2006-11-01 | 최정숙 | 고주파 전기 수술용 전극 |
US7918851B2 (en) * | 2005-02-14 | 2011-04-05 | Biosense Webster, Inc. | Irrigated tip catheter and method for manufacturing therefor |
US20080091193A1 (en) | 2005-05-16 | 2008-04-17 | James Kauphusman | Irrigated ablation catheter having magnetic tip for magnetic field control and guidance |
US7857810B2 (en) | 2006-05-16 | 2010-12-28 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Ablation electrode assembly and methods for improved control of temperature and minimization of coagulation and tissue damage |
US8128621B2 (en) | 2005-05-16 | 2012-03-06 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation electrode assembly and method for control of temperature |
US7628788B2 (en) | 2005-12-30 | 2009-12-08 | Biosense Webster, Inc. | Ablation catheter with improved tip cooling |
EP2284745A3 (fr) | 2006-04-18 | 2013-01-16 | Research In Motion Limited | Système et procédé fournissant l'accès aux informations sur un dispositif portable |
US8551085B2 (en) | 2006-10-10 | 2013-10-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Ablation electrode assembly with insulated distal outlet |
US7824406B2 (en) | 2006-12-28 | 2010-11-02 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation catheter having a valve to prevent backflow |
US8690870B2 (en) | 2006-12-28 | 2014-04-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation catheter system with pulsatile flow to prevent thrombus |
US7914528B2 (en) | 2006-12-29 | 2011-03-29 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Ablation catheter tip for generating an angled flow |
US7883508B2 (en) | 2006-12-29 | 2011-02-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Contact-sensitive pressure-sensitive conductive composite electrode and method for ablation |
US20080200801A1 (en) | 2007-02-21 | 2008-08-21 | Douglas Glenn Wildes | Mapping Movement of a Movable Transducer |
WO2008112870A2 (fr) | 2007-03-13 | 2008-09-18 | University Of Virginia Patent Foundation | Cathéter d'ablation épicardique et procédé d'utilisation |
EP2136702B1 (fr) | 2007-03-26 | 2015-07-01 | Boston Scientific Limited | Catheter electrophysiologique a haute resolution |
US8517999B2 (en) | 2007-04-04 | 2013-08-27 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated catheter with improved fluid flow |
US9855410B2 (en) | 2007-05-01 | 2018-01-02 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Optic-based contact sensing assembly and system |
US8206404B2 (en) | 2007-07-03 | 2012-06-26 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Magnetically guided catheter |
US9023030B2 (en) * | 2007-10-09 | 2015-05-05 | Boston Scientific Scimed, Inc. | Cooled ablation catheter devices and methods of use |
US20090093810A1 (en) | 2007-10-09 | 2009-04-09 | Raj Subramaniam | Electrophysiology Electrodes and Apparatus Including the Same |
US8128620B2 (en) | 2007-11-13 | 2012-03-06 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation electrode having proximal direction flow |
US8052684B2 (en) | 2007-11-30 | 2011-11-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation catheter having parallel external flow and proximally tapered electrode |
US8273082B2 (en) | 2007-12-21 | 2012-09-25 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation catheter assembly having a flow member to create parallel external flow |
US9204927B2 (en) | 2009-05-13 | 2015-12-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for presenting information representative of lesion formation in tissue during an ablation procedure |
US10660690B2 (en) | 2007-12-28 | 2020-05-26 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for measurement of an impedance using a catheter such as an ablation catheter |
US20100057072A1 (en) * | 2008-09-02 | 2010-03-04 | Medtronic, Inc. | Irrigated Ablation Catheter System and Methods |
US8348937B2 (en) | 2008-12-31 | 2013-01-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation catheter |
WO2010111785A1 (fr) | 2009-03-31 | 2010-10-07 | Sunnybrook Health Science Centre | Dispositif médical doté de moyens permettant d'améliorer la transmission d'un couple le long d'un arbre d'entraînement rotatif |
US8414579B2 (en) | 2009-06-30 | 2013-04-09 | Boston Scientific Scimed, Inc. | Map and ablate open irrigated hybrid catheter |
KR101379647B1 (ko) * | 2009-07-13 | 2014-03-28 | 보스톤 싸이엔티픽 싸이메드 인코포레이티드 | 난류를 갖는 개방 관주식 절제 카테터 |
US20110022041A1 (en) | 2009-07-24 | 2011-01-27 | Frank Ingle | Systems and methods for titrating rf ablation |
US9095349B2 (en) | 2009-12-11 | 2015-08-04 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Systems and methods for determining the likelihood of endocardial barotrauma in tissue during ablation |
US20110201973A1 (en) | 2010-02-18 | 2011-08-18 | St. Jude Medical, Inc. | Ultrasound compatible radiofrequency ablation electrode |
JP2013521935A (ja) | 2010-03-15 | 2013-06-13 | ボストン サイエンティフィック サイムド,インコーポレイテッド | 断熱された温度感知先端部を有する切除カテーテル |
US9192790B2 (en) | 2010-04-14 | 2015-11-24 | Boston Scientific Scimed, Inc. | Focused ultrasonic renal denervation |
US9949791B2 (en) | 2010-04-26 | 2018-04-24 | Biosense Webster, Inc. | Irrigated catheter with internal position sensor |
US9943363B2 (en) | 2010-04-28 | 2018-04-17 | Biosense Webster, Inc. | Irrigated ablation catheter with improved fluid flow |
US9463062B2 (en) | 2010-07-30 | 2016-10-11 | Boston Scientific Scimed, Inc. | Cooled conductive balloon RF catheter for renal nerve ablation |
US8945118B2 (en) | 2010-08-04 | 2015-02-03 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Catheter with flexible tether and introducer for a catheter |
US8715280B2 (en) | 2010-08-04 | 2014-05-06 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Magnetically guided catheters |
US9023033B2 (en) | 2010-08-04 | 2015-05-05 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Magnetically guided catheters |
US20120046610A1 (en) | 2010-08-17 | 2012-02-23 | Boston Scientific Scimed, Inc. | Methods and devices for reducing bubble formations in fluid delivery devices |
US8992519B2 (en) | 2010-11-23 | 2015-03-31 | Boston Scientific Scime, Inc. | Inverted balloon RF ablation catheter and method |
US9855094B2 (en) | 2010-12-28 | 2018-01-02 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Multi-rate fluid flow and variable power delivery for ablation electrode assemblies used in catheter ablation procedures |
US9089340B2 (en) | 2010-12-30 | 2015-07-28 | Boston Scientific Scimed, Inc. | Ultrasound guided tissue ablation |
CN103974663B (zh) | 2011-11-28 | 2016-08-24 | 阿西斯特医疗系统有限公司 | 用于成像和消融组织的导管 |
US9044156B2 (en) | 2012-12-28 | 2015-06-02 | Biosense Webster (Israel) Ltd. | Catheter with improved safety line for distal tip and related method |
WO2014151876A1 (fr) | 2013-03-15 | 2014-09-25 | Boston Scientific Scimed, Inc. | Cathéter d'ablation à irrigation ouverte ayant un refroidissement proximal |
-
2014
- 2014-03-13 WO PCT/US2014/026602 patent/WO2014151876A1/fr active Application Filing
- 2014-03-13 US US14/209,897 patent/US9615879B2/en active Active
- 2014-03-13 JP JP2016502193A patent/JP6235116B2/ja active Active
- 2014-03-13 CN CN201480016194.2A patent/CN105188588B/zh active Active
- 2014-03-13 EP EP14715792.9A patent/EP2967731B1/fr active Active
Non-Patent Citations (1)
Title |
---|
See references of WO2014151876A1 * |
Also Published As
Publication number | Publication date |
---|---|
CN105188588A (zh) | 2015-12-23 |
JP2016512715A (ja) | 2016-05-09 |
EP2967731B1 (fr) | 2020-10-07 |
US20140276759A1 (en) | 2014-09-18 |
US9615879B2 (en) | 2017-04-11 |
CN105188588B (zh) | 2017-10-10 |
WO2014151876A1 (fr) | 2014-09-25 |
JP6235116B2 (ja) | 2017-11-22 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US9615879B2 (en) | Open irrigated ablation catheter with proximal cooling | |
US9456867B2 (en) | Open irrigated ablation catheter | |
US11179196B2 (en) | Medical systems and methods for modulating nerves | |
EP3057521B1 (fr) | Cathéters à ballonnet avec fils conducteurs flexibles | |
US10660703B2 (en) | Renal nerve modulation devices | |
US20130172880A1 (en) | Renal nerve modulation devices and methods for renal nerve modulation | |
US9693821B2 (en) | Medical devices for modulating nerves | |
US20110009857A1 (en) | Open-irrigated ablation catheter with turbulent flow | |
US20150018817A1 (en) | Multiple electrode conductive balloon | |
WO2014163987A1 (fr) | Dispositifs médicaux pour la modulation des nerfs | |
CN107750146A (zh) | 开放冲洗消融导管 | |
US11026745B2 (en) | Open-irrigated ablation catheter with proximal insert cooling | |
US20140088586A1 (en) | Renal nerve modulation devices |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
PUAI | Public reference made under article 153(3) epc to a published international application that has entered the european phase |
Free format text: ORIGINAL CODE: 0009012 |
|
17P | Request for examination filed |
Effective date: 20150910 |
|
AK | Designated contracting states |
Kind code of ref document: A1 Designated state(s): AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR |
|
AX | Request for extension of the european patent |
Extension state: BA ME |
|
DAX | Request for extension of the european patent (deleted) | ||
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: EXAMINATION IS IN PROGRESS |
|
17Q | First examination report despatched |
Effective date: 20190125 |
|
GRAP | Despatch of communication of intention to grant a patent |
Free format text: ORIGINAL CODE: EPIDOSNIGR1 |
|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: GRANT OF PATENT IS INTENDED |
|
RIC1 | Information provided on ipc code assigned before grant |
Ipc: A61M 25/00 20060101ALN20200327BHEP Ipc: A61B 18/14 20060101AFI20200327BHEP Ipc: A61B 17/00 20060101ALN20200327BHEP Ipc: A61B 18/00 20060101ALN20200327BHEP |
|
INTG | Intention to grant announced |
Effective date: 20200420 |
|
GRAS | Grant fee paid |
Free format text: ORIGINAL CODE: EPIDOSNIGR3 |
|
GRAA | (expected) grant |
Free format text: ORIGINAL CODE: 0009210 |
|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: THE PATENT HAS BEEN GRANTED |
|
AK | Designated contracting states |
Kind code of ref document: B1 Designated state(s): AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR |
|
REG | Reference to a national code |
Ref country code: GB Ref legal event code: FG4D |
|
REG | Reference to a national code |
Ref country code: CH Ref legal event code: EP Ref country code: AT Ref legal event code: REF Ref document number: 1320334 Country of ref document: AT Kind code of ref document: T Effective date: 20201015 |
|
REG | Reference to a national code |
Ref country code: DE Ref legal event code: R096 Ref document number: 602014070961 Country of ref document: DE |
|
REG | Reference to a national code |
Ref country code: IE Ref legal event code: FG4D |
|
REG | Reference to a national code |
Ref country code: NL Ref legal event code: MP Effective date: 20201007 |
|
REG | Reference to a national code |
Ref country code: AT Ref legal event code: MK05 Ref document number: 1320334 Country of ref document: AT Kind code of ref document: T Effective date: 20201007 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: GR Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20210108 Ref country code: FI Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 Ref country code: RS Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 Ref country code: NL Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 Ref country code: PT Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20210208 Ref country code: NO Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20210107 |
|
REG | Reference to a national code |
Ref country code: LT Ref legal event code: MG4D |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: BG Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20210107 Ref country code: ES Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 Ref country code: AT Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 Ref country code: LV Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 Ref country code: SE Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 Ref country code: PL Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 Ref country code: IS Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20210207 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: HR Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 |
|
REG | Reference to a national code |
Ref country code: DE Ref legal event code: R097 Ref document number: 602014070961 Country of ref document: DE |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: LT Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 Ref country code: SK Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 Ref country code: RO Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 Ref country code: SM Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 Ref country code: CZ Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 Ref country code: EE Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 |
|
PLBE | No opposition filed within time limit |
Free format text: ORIGINAL CODE: 0009261 |
|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: NO OPPOSITION FILED WITHIN TIME LIMIT |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: DK Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 |
|
26N | No opposition filed |
Effective date: 20210708 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: IT Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 Ref country code: MC Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 Ref country code: AL Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 |
|
REG | Reference to a national code |
Ref country code: CH Ref legal event code: PL |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: SI Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 |
|
REG | Reference to a national code |
Ref country code: BE Ref legal event code: MM Effective date: 20210331 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: IE Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20210313 Ref country code: FR Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20210331 Ref country code: LI Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20210331 Ref country code: LU Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20210313 Ref country code: CH Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20210331 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: IS Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20210207 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: BE Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES Effective date: 20210331 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: HU Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT; INVALID AB INITIO Effective date: 20140313 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: CY Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 |
|
PG25 | Lapsed in a contracting state [announced via postgrant information from national office to epo] |
Ref country code: MK Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT Effective date: 20201007 |
|
PGFP | Annual fee paid to national office [announced via postgrant information from national office to epo] |
Ref country code: DE Payment date: 20240220 Year of fee payment: 11 Ref country code: GB Payment date: 20240220 Year of fee payment: 11 |